Adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in sub-Saharan Africa: a systematic review and meta-analysis
- Publisher:
- Taylor and Francis
- Publication Type:
- Journal Article
- Citation:
- Journal of Pharmaceutical Policy and Practice, 2023, 16, (1), pp. 137
- Issue Date:
- 2023-11-07
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BackgroundAdherence to evidence based standard treatment guidelines STGs enable healthcare providers to deliver consistently appropriate diagnosis and treatment Irrational use of antimicrobials significantly contributes to antimicrobial resistance in sub Saharan Africa SSA The best available evidence is needed to guide healthcare providers on adherence to evidence based implementation of STGs This systematic review and meta analysis aimed to determine the pooled prevalence of adherence to evidence based implementation of antimicrobial treatment guidelines among prescribers in SSA MethodsThe review followed the JBI methodology for systematic reviews of prevalence data CINAHL Embase PubMed Scopus and Web of Science databases were searched with no language and publication year limitations STATA version 17 were used for meta analysis The publication bias and heterogeneity were assessed using Egger s test and the I2 statistics Heterogeneity and publication bias were validated using Duval and Tweedie s nonparametric trim and fill analysis using the random effect analysis The summary prevalence and the corresponding 95 confidence interval CI of healthcare professionals compliance with evidence based implementation of STG were estimated using random effect model The review protocol has been registered with PROSPERO code CRD42023389011 The PRISMA flow diagram and checklist were used to report studies included excluded and their corresponding section in the manuscript ResultsTwenty two studies with a total of 17 017 study participants from 14 countries in sub Saharan Africa were included The pooled prevalence of adherence to evidence based implementation of antimicrobial treatment guidelines in SSA were 45 The pooled prevalence of the most common clinical indications were respiratory tract 35 and gastrointestinal infections 18 Overall prescriptions per wards were inpatients 14 413 and outpatients 12 845 Only 391 prescribers accessed standard treatment guidelines during prescr
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